A veterinary nurse strikes and maims a cyclist – a father of two young children – while driving home from the practice after working a double shift. Another healthcare professional on a graveyard shift in an emergency hospital, falls asleep on the job, and an ICU patient dies after receiving insufficient oxygen. The CDC conducted a survey of our profession in 2014, and the survey results, based on answers from more than 10,000 practicing veterinarians—most (69 percent) of whom are in small animal practice—revealed the following:
- 8 percent of males and 10.9 percent of females in the profession have serious psychological distress compared with 3.5 percent and 4.4 percent of theU.S.male and female adults.
- 5 percent of males and 36.7 percent of females in veterinary medicine have experienced depressive episodes since veterinary school, which is about 1 1/2 times the prevalence in U.S. adults overall throughout their lifetime.
- 4 percent of males and 19.1 percent of females who are veterinarians have considered suicide since graduation. This is three times the U.S. national mean.
- 1.1 percent of males and 1.4 percent of females in the veterinary profession have attempted suicide since veterinary school.
The two examples are extremes, but the CDC survey shares real-life examples of bolstering growing evidence that when veterinary nurses, veterinarians, and other members of the healthcare team are fatigued, they are more likely to jeopardize others or make a clinical mistake, regardless of their qualifications, compassion and dedication.
A recent report, commissioned by Kronos Inc., and conducted by Health Leaders Media, indicated more than 25 percent of nurses surveyed said fatigue caused them to make an effort at work. The report went on to say that the figure may actually be higher because many nurses, physicians and other staff members are likely unaware when fatigue affects their judgement.
Rebecca Rose (Catalyst) just shared this information in her newsletter:
According to the article, How to deal with workplace Conflicts1, human resource managers can spend anywhere from 24 to 60 percent of their time trying to resolve workplace conflicts. You may believe that “tiptoeing around” and avoiding conflict will make it go away. Think again! Avoiding conflict makes it worse.
- 22% say they’re putting less effort into their work due to conflicts at work.
- 28% have lost work time in their attempts to avoid confrontations.
- 37% are less committed to their employer because of a hostile workplace altercation.
- 48% of employees report that they have experienced abusive behavior at work.
- 60% have claimed that conflict between members of their veterinary team was a problem.
- 92% of veterinarians, practice owners, practice managers, technicians, receptionists and assistants say they have worked on a toxic team.
If these sound like challenges you deal with, then you are obviously not alone. Conflict doesn’t just affect the people either. “Animals can sense tensions and become more fractious as a result.” It’s important to educate yourself on interpersonal skills and reach out for help when needed. Workplaces that accept differences, understand attitudes and encourage open dialogue offer safe environments to bring conflict to light. Although the issue of healthcare provider work hours and sleep deprivation has been studied for years, healthcare leadership has been slow to enforce policies addressing fatigue, and veterinary medicine has been GLACIAL!
NEED FOR ACTION
In 2010, human healthcare teaching hospitals were required to place an 80-hour weekly limit on house staff; however a recent survey showed there were no teaching institutions that had an effective policy for residents, and in their assessment, “The situation is worse for other healthcare providers.”
When I was setting up the newly formed Veterinary Teaching Hospital (VTH) at Roseworthy, South Australia, I used a different approach.
FIRST – I established our VTH operations as a commercial enterprise, outside the control of the University.
SECOND – I left all the “specialists” with the head of school, and only hired 3 clinicians and 10 veterinary nurses, plus part-time client relations and maintenance staff.
THIRD – my nursing staff had 4 eight-hour shifts a week, plus 8-hours flex time for lesson plans, administration, and student coaching.
FOURTH – we were 45 minutes north of Adelaide, with mostly bedroom communities around us, so our outpatient VTH companion animal clinical hours were 1600 to 2100 hrs weekdays. This pleased the local practitioners when I presented it, telling them they could now go home and have supper with their families.
FIFTH – mornings were for specialty referrals and inpatient intake for the specialists. Mid-day was time for local clinicians to bring in their patients for imaging, second opinions and other support, and still get their patients home for discharge.
NOTE: Australia has a federally mandatory wage system (e.g., anyone in a veterinary nurse position starts at $20, regardless of personal skills). Veterinary nurses have the minimum wage from 0630 to 2130 every day of the week, then the go to time-and-a-half; University had weekday minimum wage from 8 a.m. to 5 p.m. then time-and-a-half to 9 p.m., with double time from 9 p.m. to 8 a.m., and then Saturday was double time until 9 p.m., followed by 2.5 times from 9 p.m. Saturday to 8 a.m. Monday. As a commercial activity, I did not have to follow the University escalated wages.